Author Question: The statement that provides the best rationale for the nursing intervention of monitoring the ... (Read 102 times)

Mollykgkg · **on:** Jul 19, 2018

The statement that provides the best rationale for the nursing intervention of monitoring the severely
depressed client closely during antidepressant therapy is

a. as depression lifts, physical energy becomes available to carry out a plan for
suicide.
b. suicide may be precipitated by a variety of internal and external events.
c. suicidal clients have difficulty using social supports.
d. suicide is an impulsive act.

Question 2

B and J both have Alzheimer's disease. B walks up behind J in the hall and shouts Move along,
you're blocking the road. I'll take a stick to you..

J turns around, shakes his fist, and shouts I know
what you're up to, you're trying to steal my car.. The best action for the nurse to take would be to
a. reinforce reality by telling B that J can walk in the hall, and telling J that B is not
trying to steal his car.
b. ask the medication nurse to give both clients an as-needed dose of neuroleptic
medication.
c. separate and distract them by directing one to go to the day room and taking the
other to the activities area.
d. step between them, saying Gentlemen, please quiet down. We do not permit
physical violence here..

reelove4eva · **Reply #1 on:** Jul 19, 2018

Answer to Question 1

A
Antidepressant medication has the objective of relieving depression. Risk for suicide is greater as the
depression lifts, primarily because the client has more physical energy at a time when he or she may
still have suicidal ideation. The other options have little to do with nursing interventions relating to
antidepressant medication therapy.

Answer to Question 2

C
Separating and distracting prevents escalation from verbal to physical acting out. Neither client loses
self-esteem during this intervention, and medication will probably not be necessary. Stepping
between two angry, threatening clients is an unsafe action, and trying to reinforce reality during an
angry outburst will probably not be successful when the clients are cognitively impaired.